Effect of Single- versus Double-Layer Uterine Closure during Caesarean Section on Niche Formation and Menstrual Irregularity

Background: The myometrium at the location of the CS (caesarean section) scars, also known as residual myometrium thickness (RMT), is larger after a double-layer uterine closure procedure than following a single-layer one. It may lessen the formation of a niche that is the myometrium’s disruption at the location of the scar of the uterus. Gynecological manifestations, obstetric problems in a future pregnancy and birth, and maybe subfertility are linked to thin RMT and a niche. Objective: To ascertain if double-layer unlocked closure of the uterus is better than single-layer one in terms of post-menstrual spotting and niche development following a first CS. Patients and Methods: In this randomized clinical study, 287 patients were evaluated for qualifying. Of all eligible individuals, 57 patients were excluded from the study based on the inclusion criteria. Results: The variation in ages, gestational age, body mass index (BMI), and cesarean section indications between the two assigned groups is statistically insignificant. However, postmenstrual spotting was statistically significantly more common in single-layer group compared to in double-group. The current study revealed ultrasound findings suggestive of niche formation was statistically significantly more common in single-layer group compared to in double-layer group. Conclusion: As evident from the current study, it demonstrates the advantages of double-layer unlocked closure of the uterus over single-layer one in terms of post-menstrual spotting and niche development following first-time cs. Thus, we deduced that fewer niches are formed, and fewer menstrual spotting occurs in the presence of double unlocked layers closure. To ascertain the impact of uterus closure method on post-operative niche development and the risk of obstetrics and gynaecological problems, further prospective trials with extended follow-up periods are required.

Fracture evolution characteristics of sandstone containing double fissures and a single circular hole under uniaxial compression

The uniaxial compression experiments on the sandstone samples containing double fissures and a single circular hole were carried out by using electro-hydraulic servo universal testing machine to investigate the effect of rock bridge angle β and fissure angle α on mechanical properties and evolution characteristics of cracks.The results show that the peak strength,peak strain and elastic modulus of defected specimens decrease comparing with those for intact sample,and show a decreased trend firstly and then increase with β changing from 0° to 90°.The peak strength and elastic modulus achieve the minimum value as the rock bridge angle is 60°,while the peak strain reaches the minimum value with the rock bridge angle of 45°.The crack initiation of tested rock samples occurs firstly in stress concentration areas at tips of prefabricated fissures under uniaxial compression,and then propagates constantly and coalescences with the prefabricated hole.Some secondary cracks initiate and propagate as well until buckling failure happens.The rock bridge angle has a great influence on crack initiation,coalescence,final failure mode,crack initiation stress and transfixion stress.The peak strength varies significantly,while the elastic modulus and peak strain change slightly,and the failure modes are also different due to the influence of fissure angle.

Adsorption and desorption of hydrogen on/from single-vacancy and double-vacancy graphenes

Adsorption and desorption of hydrogen on/from single-vacancy and double-vacancy graphenes were studied by means of first-principles calculations. The structure and stability of continuous hydrogenation in single vacancy were investigated. Several new stable structures were found, along with their corresponding energy barriers. In double-vacancy graphene, the preferred sites of H atoms were identified, and H2 molecule desorption and adsorption of from/on were calculated from the energy barriers. This work provides a systematic and comprehensive understanding of hydrogen behavior on defected graphene.

Treatment of Complex Proximal Tibial Fractures (Types V &VI of Schautzker Classification) by Double Plate Fixation with Single Anterior Incision

Background: complex proximal tibial fractures (Types V & VI of Schautzker classification) are the major problems in orthopedic surgery and associated with high complication rates. There are many alternatives in treatment of these fractures. Aim: to evaluate the results of double plating with single anterior incision in complex proximal tibial fractures (Types V& VI of Schautzker classification).Methods and Materials: 22 patients (16 males and 6 females) with Types V and VI of Schautzker classification of proximal tibial fractures (14 cases were Type V and 8 cases were Type VI) were treated by double plating with single anterior incision method between May 2006 and May 2011. The bony and functional outcome was evaluated according to Knee Society Score. Results: According to Knee Society Score, the results were as follows: excellent in 19 patients (86.4%), good in 2 patients (9.1%), fair in 1 patient (4/5%), and poor in no patient (0%).Conclusion: the double plate fixation with single anterior incision is the best, effective and simple procedure in treatment of complex proximal tibial fractures (Types V and VI of Schautzker classification).

Techno-economic analysis of single U-tube and double U-tube heat exchangers in Chongqing area

On the basis of practical projects in Chongqing,the thermal performance of heat exchangers (single U-tube type and double U-tube type) of the ground-source heat pump (GSHP) system in the hot summer was obtained and analyzed. The data obtained from test could match with the result deduced from theoretical calculation. From the test results,the cooling capacity of double U-tube is 1.6 times that of single U-tube. Taking cost per depth per watt Clq as the evaluation standard,Clq of single U-tube is 4.69 RMB$/W,and Clq of double U-tube is 3.14 RMB$/W. The double U-tube heat exchangers usage should be prioritized.

Comparative Analysis between Single Diode and Double Diode Model of PV Cell: Concentrate Different Parameters Effect on Its Efficiency

This research appraises comparative analysis between single diode and double diode model of photovoltaic (PV) solar cells to enhance the conversion efficiency of power engendering PV solar systems. Single diode model is simple and easy to implement, whereas double diode model has better accuracy which acquiesces for more precise forecast of PV systems performance. Exploration is done on the basis of simulation results and MATLAB tool is used to serve this purpose. Simulations are performed by varying distinct model parameters such as solar irradiance, temperature, value of parasitic resistances, ideality factor of diode and number of series and parallel connected solar cells used to assemble PV array. Conspicuous demonstration is executed to analyze effects of these specifications on the efficiency curve and power vs. voltage output characteristics of PV cell for specified models.

Comparison between double-balloon and single-balloon enteroscopy in therapeutic ERC after Roux-en-Y entero-enteric anastomosis

AIM:To compare the efficacy of double-balloon enteroscopy (DBE) and single-balloon enteroscopy (SBE) in therapeutic endoscopic retrograde cholangiography (ERC) in patients with Roux-en-Y entero-enteric anastomosis.METHODS:Retrospective analysis of our patient cohort revealed 4 patients with enterobiliary anastomosis and Roux-en-Y entero-enteric anastomosis who underwent repeated ERC with DBE and SBE because of recurrent cholangitis.RESULTS:A total of 38 endoscopic retrograde cholangiopancreatography procedures were performed in 25 patients with Roux-en-Y entero-enteric anastomosis.DBE was used in 29 procedures and SBE in 9.The 4 patients who underwent repeated ERC with DBE and SBE suffered from recurrent cholangitis due to stenosis of the enterobiliary anastomosis.ERC was performed repeatedly to achieve balloon dilation with/without biliary stone extraction and multiple stent placement at the level of the enterobiliary anastomosis.In all 4 patients DBE and SBE were equally successful.Compared to DBE,SBE was equally effective in passing the Roux-en-Y entero-enteric anastomosis,reaching the enterobiliary anastomosis and performing therapeutic ERC.CONCLUSION:This retrospective comparison shows that DBE and SBE are equally successful in the performance of therapeutic ERC at the level of the enterobiliary anastomosis after Roux-en-Y entero-enteric anastomosis.

Utility of single and double balloon endoscopy in patients with difficult colonoscopy: A randomized controlled trial

AIM: To compare the utility of single-balloon colonoscopy (SBC) or double-balloon colonoscopy (DBC) for difficult colonoscopies. METHODS: Between August 2008 and June 2010, patients in whom total colonoscopy failed within 30 min of insertion were assigned randomly to undergo either SBC or DBC. No sedatives were used. After the endoscopy, all patients were asked to evaluate pain during the procedure on a 10-point analog scale (1 = no pain; 10 = worst imaginable pain) with a questionnaire. The study outcomes were the cecal intubation rate and time, endoscopic findings, complications, and pain score. RESULTS: The SBC and DBC groups included 11 and 10 patients, respectively. All but one SBC patient achieved total colonoscopy successfully. The cecal intubation times were 18 min (range: 10-85 min) and 12.8 min (range: 9.5-42 min) in the SBC and DBC groups, respectively (P= 0.17). No difference was observed in the prevalence of colon polyps between the SBC and DBC groups (45% vs 30%, P = 0.66). SBC showed advanced colon cancer in the ascending colon, which was inaccessible using conventional colonoscopy. The respective pain scores were 5 (1-10) [median (range)] and 5 (1-6) in the SBC and DBC groups (P = 0.64). No complications were noted in any patient. CONCLUSION: The utility of singleand double-balloon endoscopy for colonoscopy seems comparable in patients with incomplete colonoscopy using a conventional colonoscope.

Single and double Auger decay of 4f-ionized mercury including cascade and direct processes

Single（SA） and double（DA） Auger decay including cascade and direct processes are investigated for Hg 4 f^（-1） with multiconfiguration Dirac–Fock method and two-step approaches, i.e., knockout and shakeoff mechanisms. Due to the computational effort, only the major transitions are considered to describe the SA and DA decays for the Hg＋ions with complex electronic configurations. In order to estimate the Auger transition energies and amplitudes, the reference configuration sets producing the configuration state functions are carefully chosen for balancing electron correlations among the successive singly, doubly and triply ionized mercury. The Auger rates and electron spectra, DA probabilities as well as the populations of the final Hg^（3＋）states are obtained. Our results well explain the recent experimental data about the 4 f hole states of Hg[Palaudoux J et al., Phys. Rev. A 91 012513（2015）], and could provide guidance for further studies on complex atoms.Particularly for the DA decay, the contributions of the direct processes, which are neglected in their calculations, are found to be important, accounting for as high as about 38% and 34% of the total DA decays for the 4 f（7/2）^（-1） and 4 f（5/2）^（-1）, respectively.

Single and double aging treatments on Mg97Zn1Y2 alloy

The development of magnesium alloys was limited due to the low absolute strength and poor corrosion resistance. It was found that the optimal performance could not be achieved in some alloys by a single quenching and aging treatment, but could be achieved after a graded aging or multiple-stage aging heat treatment. The Mg97Zn1Y2 alloy was prepared and subjected to single and double aging treatments. Single aging was carried out at 250 ℃ for 6 to 15 h. For double aging, the first step was performed the same as the single aging. The second step was performed at 350 ℃ for 12 h. The microstructure and properties of the alloy with single and double aging were analyzed by means of hardness measurement, optical microscopy, scanning electron microscopy, X-ray diffraction, and polarization curve measurements. Results show that the precipitated nanoscale phases are formed during aging, and evenly distributed in the matrix. Compared with the single aging treatment, the hardness and corrosion resistance of the alloy are further improved due to the double aging treatment.

Amplified Spontaneous Emission in Single Frequency Double-Clad Fiber Power Amplifiers

Amplified spontaneous emission （ASE） in diode laser pumped double-clad fiber power amplifiers is studied experimentally, The dependences of ASE on fiber length and cross section of active core are discussed and the variations of ASE power as the function of pumping and signal power are investigated. There are indications that long fibers with large mode area need stronger input signals to suppress ASE. It is shown that a 150 mW input signal can suppress the ASE by 40 dB in a 4 m large mode area fiber, while to efficiently suppress the ASE in a 10 m fiber, stronger input signal is needed. 12.5 W and 16.1 W single frequency CW output power are obtained from 4 m fiber and 10 m fiber respectively. No stimulated Brillouin scattering （SBS） was observed

Designer Mg-Mg and Zn-Zn Single Bonds Facilitated by Double Aromaticity in the M2B7^-(M=Mg,Zn)Clusters

The simple homodinuclear M-M single bonds for group II and XII elements are difficult to obtain as a result of the fulfilled s2electronic configurations,consequently,a dicationic prototype is often utilized to design the M^+-M^+single bond.Existing studies generally use sterically bulky organic ligands L^-to synthesize the compounds in the L^--M^+-M^+-L-manner.However,here we report the design of Mg-Mg and Zn-Zn single bonds in two ligandless clusters,Mg2B7-and Zn2B7-,using density functional theory methods.The global minima of both of the clusters are in the form of M2^2+(B7^3-),where the M-M single bonds are positioned above a quasi-planar hexagonal B7 moiety.Chemical bonding analyses further confirm the existence of Mg-Mg and Zn-Zn single bonds in these clusters,which are driven by the unusually stable B7^3-moiety that is bothσandπaromatic.Vertical detachment energies of Mg2B7-and Zn2B7-are calculated to be 2.79 e V and 2.94 e V,respectively,for the future comparisons with experimental data.

Stable continuous-wave single-frequency intracavity frequency-doubled laser with intensity noise suppressed in audio frequency region

We demonstrated a continuous wave(cw) single-frequency intracavity frequency-doubled Nd:YVO_4/LBO laser with 532 nm output of 7.5 W and 1.06 μm output of 3.1 W, and low intensity noise in audio frequency region.To suppress the intensity noise of the high power 532 nm laser, a laser frequency locking system and a feedback loop based on a Mach-Zehnder interferometer were designed and used.The influences of the frequency stabilization and the crucial parameters of the MZI, such as the power splitting ratio of the beam splitters and the locking state of the MZI, on the intensity noise of the 532 nm laser were investigated in detail.After the experimental optimizations, the laser intensity noise in the frequency region from 0.4 kHz to 10 kHz was significantly suppressed.

Double Intervention in Single Sitting: Percutaneous Device Closure and Permanent Pacemaker Implantation in a Patient with Atrial Septal Defect

Context: Atrial septal defect may rarely be associated with other cardiac diseases such as arrhythmia, and may require additional intervention. Case report: A 16-year-old boy presented with effort dyspnea, tiredness, and fatigue. The electrocardiograph revealed right bundle branch block, atrioventricular block, and left axis deviation. Ostium secundum type of atrial septal defect was detected by transthoracic echocardiography and was confirmed by transesophageal echocardiography. The patient was advised to undergo percutaneous device closure. Permanent pacemaker implantation was also suggested considering the risk of fatal arrhythmias associated with atrioventricular block. Consequently, patient underwent percutaneous atrial septal defect closure and implantation of pacemaker in a single sitting. Both the procedures were successful, after which the patient showed remarkable symptomatic improvement. Conclusion: In atrial septal defect patients with unexplained atrioventricular block, closure of atrial septal defect and implantation of pacemaker in single sitting appear to be an attractive modality.

Saturation Dislocation Microstructures of Double-slip-oriented Copper Single Crystal during the Corrosion Fatigue in a 0.5 mol/L NaCl Aqueous Solution

Copper single crystal specimens with the longitudinal axis parallel to the [013] double-slip-orientation were grown through Bridgman technique. The fatigue tests were performed using a symmetric tension-compression load mode at room temperature in an open-air and a 0.5 mol/L NaCl solution, respectively. The dislocation microstructures were observed with scanning electron microscopy (SEM) by the electron channeling contrast (ECC) and transmission electron microscopy (TEM). The results show that the saturation dislocation microstructures during the corrosion fatigue in the aqueous solution of 0.5 mol/L NaCI, mainly consisted of labyrinth, wall and vein dislocation structures, which differs from the dislocation structures of the walls and veins in an open-air environment.

Double-Lumen Needle Follicular Flushing System versus Single-Lumen Aspiration Needle in IVF/ICSI Patients with Poor Ovarian Response: A Meta-Analysis

Background: The present study performed a meta-analysis to comprehensively analyze existing randomized controlled trials (RCT) involving the use of double-lumen needle in patients with poor ovarian response to explore whether double-lumen needle was good for specific patients. Methods: The PubMed, EMBASE, Cochrane Library databases and two randomized controlled trials registration centers were thoroughly searched until April 2017. The clinical outcomes of IVF/ICSI cycles were compared between two groups with double-lumen needle and single-lumen needle. Results: Four RCT studies were included in this present meta-analysis. The oocytes yield was similar in two groups (OR 0.88, 95%CI 0.66 - 1.16;I2 = 4%). The procedure time with double-lumen needle was significantly longer than that with single-lumen needle (IV = 1.98, 95%CI 0.95 - 3.00;I2 = 86%). The fertilization rate with double-lumen needle was lower than that with single-lumen needle (OR 0.66, 95%CI 0.44 - 0.97;I2 = 0%). There was no significant difference of live birth rate in two groups (OR 0.76, 95%CI 0.32 - 1.76;I2 = 41%). Conclusion: Double-lumen needle could not benefit patients with a POR in terms of the number of oocytes retrieved, oocyte recovery rate, normal fertilization rate, clinical pregnancy rate, and live birth rate, compared with single-lumen needle.

人参皂苷Rg1通过自噬抑制Raw 264.7巨噬细胞凋亡

目的探讨人参皂苷Rg1在血清剥夺诱导的Raw 264.7巨噬细胞自噬和凋亡中的作用及其机制。方法体外培养小鼠Raw 264.7巨噬细胞随机分为空白对照组、不同时间(12、24、36、48和60h)血清剥夺处理组、人参皂苷Rg1(50μmol/L)+不同时间(24、36和48h)血清剥夺处理组;依据最佳血清剥夺时间进一步分为空白对照组、血清剥夺(36h)处理组、人参皂苷Rg1(50μmol/L)+血清剥夺(36h)处理组、人参皂苷Rg1(50μmol/L)+血清剥夺(36h)+3-甲基腺嘌呤(3-MA)(5mmol/L,1h)处理组。采用Western blotting检测LC3、Atg 5、Beclin 1、cleaved Caspase-3、Bcl-2及Bax蛋白水平的表达变化;采用免疫荧光双标记检测细胞内LC3蛋白水平表达的变化;采用Hoechst 33342/PI荧光双染检测细胞凋亡的变化。结果不同时间(12、24、36、48和60h)血清剥夺诱导Raw264.7巨噬细胞凋亡;与血清剥夺处理组相比,人参皂苷Rg1处理组LC3、Atg 5及Beclin 1蛋白表达水平显著上调;加入3-MA抑制剂后,凋亡细胞较人参皂苷Rg1处理组明显增多,且Bcl-2蛋白表达水平明显下调的同时,cleaved Caspase-3和Bax蛋白表达水平则显著上调。结论人参皂苷Rg1通过促进血清剥夺诱导的Raw 264.7巨噬细胞自噬,发挥抗凋亡的保护作用。

行距配置和种植密度对棉花干物质生产及产量的影响

行距配置和种植密度是影响棉花产量和品质的重要因素。当前新疆棉花种植主要采用宽窄行配置,也有等行距配置方式,但对这两种方式的认识尚存在争议。为此,本研究以中棉所88号为供试材料,采用裂区设计,行距配置(等行距和宽窄行)为主区,种植密度12×104株hm^(–2) (D1)、16×104株hm^(–2) (D2)和18×104株hm^(–2) (D3)为裂区,开展了2年大田试验,比较研究了行距配置和密度对棉花群体生长发育、干物质积累和分配、以及产量和纤维品质的影响。结果表明,中等密度(16×10^(4)株hm^(–2))下等行距和宽窄行处理组合的叶面积指数(LAI)增速、LAI峰值,以及吐絮期生殖器官生物量的分配比例均高于其他处理组合,且二者无显著差异。各处理组合间的棉花群体生长率(CGR)、净同化率(NAR)和棉铃生长率(BGR)均无显著差异。2年平均,中等密度下等行距和宽窄行处理组合的籽棉产量相当,纤维品质指标也无显著差异。表明在中等密度下,无论采用等行距还是宽窄行种植模式,均能达到理想的产量和品质。本研究为新疆棉花行距配置和密度选择提供了科学依据。

白藜芦醇抑制脂多糖诱导破骨前体细胞Raw264.7的激活

目的探讨白藜芦醇(Res)对脂多糖(LPS)诱导的破骨前体细胞Raw 264.7细胞系释放炎性细胞因子的抑制作用。方法采用LPS刺激Raw 264.7细胞构建炎症模型,采用抗酒石酸酸性磷酸酶(TRAP)染色鉴定细胞,采用MTT检测Res对Raw 264.7细胞的毒性影响,免疫荧光双标以及反转录聚合酶链反应(RT-PCR)方法检测不同浓度Res(1μmol/L和5μmol/L)对细胞炎性因子:肿瘤坏死因子-α(TNF-α)和白细胞介素-1β(IL-1β)与细胞炎性蛋白酶:诱导型一氧化氮合酶(i NOS)和环氧合酶-2(COX-2)、炎性信号蛋白核因子-κB(NF-κB)蛋白与mRNA的表达变化。结果不同浓度的Res(1μmol/L和5μmol/L)在翻译水平和转录水平上明显抑制了LPS诱导的细胞炎性蛋白酶i NOS和COX-2表达,同时了抑制细胞炎性因子IL-1β与炎性信号蛋白NF-κB的上调。结论 Res可能通过NF-κB调控LPS诱导的Raw 264.7细胞炎性细胞因子的释放进而抑制破骨前体细胞的激活,进而具有抗骨质疏松的作用。

Two case reports of acute upper gastrointestinal bleeding from duodenal ulcers after Roux-en-Y gastric bypass surgery: Endoscopic diagnosis and therapy by single balloon or push enteroscopy after missed diagnosis by standard esophagogastroduodenoscopy

The diagnosis and opportunity for endoscopic therapy of gastric or duodenal lesions may be missed at esophagogastroduodenoscopy(EGD) because of technical difficulty in intubating at EGD the postoperatively excluded stomach and proximal duodenum in patients status post Roux-en-Y gastric bypass(RYGB). Two cases are reported of acute upper gastrointestinal bleeding 10 or 11 years status postRYGB, performed for morbid obesity, in which the EGD was non-diagnostic due to failure to intubate the excluded stomach and proximal duodenum, whereas subsequent push enteroscopy or single balloon enteroscopy were diagnostic and revealed 4-cm-wide or 5-mm-wide bulbar ulcers and even permitted application of endoscopic therapy. These case reports suggest consideration of push enteroscopy, or single balloon enteroscopy, where available, in the endoscopic evaluation of acute UGI bleeding in patients status post RYGB surgery when the EGD was non-diagnostic because of failure to intubate these excluded segments.